Provider Demographics
NPI:1508558909
Name:ANDERSON, EMMA DAWN (MSW-I)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:DAWN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW-I
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:DAWN
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1497 N 1285 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-6537
Mailing Address - Country:US
Mailing Address - Phone:480-678-8741
Mailing Address - Fax:
Practice Address - Street 1:165 N 1330 W STE A1
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-5116
Practice Address - Country:US
Practice Address - Phone:801-218-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical